Organization
BLUEGLOVE PRIMARY CARE LLC
Active
Organization
BLUEGLOVE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIEXI LIAO PHD (MANAGING MEMBER)
(770) 405-9320
Entity
Organization
Contact information
Practice address
815 PINE MNR, MARIETTA, GA 30066-3837
(770) 405-9320
Mailing address
815 PINE MNR, MARIETTA, GA 30066-3837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/23/2026
Last updated
07/23/2026
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